| 昝星有,李明,周卫平,刘明芃,李娜,吴鹏西,方向明.灰阶超声造影结合MRI对乳腺肿块生长方位的重新认识[J].中国医学影像技术,2020,36(1): |
| 灰阶超声造影结合MRI对乳腺肿块生长方位的重新认识 |
| Gray - scale contrast-enhanced ultrasonography combined with MRI to re-recognize the growth orientation of breast masses |
| 投稿时间：2019-04-09 修订日期：2020-01-08 |
| DOI： |
| 中文关键词: 乳腺癌 方位 超声检查 核磁共振成像 |
| 英文关键词:Breast Cancer Orientation Ultrasonography Magnetic Resonance Imaging |
| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目） |
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| 中文摘要: |
| 【摘要】目的 超声造影（CEUS）结合MRI研究乳腺肿块的生长方位。方法 2009年1月至2019年1月接受检查和治疗的乳腺肿块患者103例，常规超声（CUS）显示为非平行位生长，CEUS资料齐全，其中20例行MRI检查。根据2013版BI-RADS-US，生长方位的判断基于目测法。良恶性组生长方位的差异比较采用?2检验，CEUS与MRI对肿块方位判断有无区别采用McNemar检验。CEUS与MRI对肿块方位判断的一致性采用Kappa检验。结果 良性肿块35例，恶性肿块68例，CEUS后显示乳腺良性肿块生长方位改变4例，不改变31例；恶性肿块生长方位改变59例，不改变9例，?2=55.210，P=0.000（P<0.05）。以病理为金标准，超声造影生长方位的改变诊断乳腺良恶性肿块的敏感性93.7%，特异性77.5%，阳性预测值86.8%，阴性预测值88.6%。MRI显示19例乳腺癌生长方位与CEUS一致，经McNemar检验，P=0.500（P>0.05），CEUS与MRI对肿块方位的判定无显著性差别。经Kappa一致性检验，Kappa =0.828。结论 CUS显示的非平行位生长的乳腺良性肿块在CEUS后仍多表现为非平行位生长，而乳腺恶性肿块CEUS后多表现为平行位生长。CEUS与MRI显示肿块生长方位一致性良好。CEUS较CUS对于乳腺肿块生长方位的判定更为可靠。 |
| 英文摘要: |
| 【Abstract】Objective Contrast-enhanced ultrasonography (CEUS) combined with breast MRI was used to study the growth orientation of breast masses. Methods From January 2009 to January 2019, 103 cases of breast masses were examined and treated. Conventional ultrasound showed non - parallel - orientation growth. CEUS data were complete. Twenty of them underwent MRI. According to the 2013 BI-ADS-US, the judgment of growth orientation is based on visual measurement. The difference in growth directions of the benign and malignant groups was compared using ?2 test. McNemar test was used to determine whether there was a difference between CEUS and MRI in the orientation of the mass. Kappa test was used to determine the consistency of contrast-enhanced ultrasonography and MRI in determining the orientation of the mass. Result There were 35 cases of benign mass and 68 cases of malignant mass. After contrast ultrasonography, the growth orientation of benign breast mass was changed in 4 cases but not in 31 cases. There were 59 cases with malignant tumor growth orientation change, but no change in 9 cases(?2=55.210，P=0.000（P<0.05）). The sensitivity, specificity, positive predictive value and negative predictive value of contrast-enhanced ultrasonography in the diagnosis of benign and malignant breast masses were 93.7%, 77.5%, 86.8% and 88.6%, respectively. MRI showed that the growth orientation of 19 cases of breast cancer was consistent with CEUS, According to McNemar test, P=0.500(P>0.05), there was no significant difference between CEUS and MRI in the determination of mass orientation. According to the Kappa consistency test, the Kappa value =0.828. Conclusion A benign breast mass shown by conventional ultrasonography in non-parallel position still showed non-parallel growth after contrast-enhanced ultrasonography. However, malignant breast masses show parallel growth after contrast-enhanced ultrasonography. The contrast-enhanced ultrasound showed a good consistency with MRI in determining the orientation of the mass. Contrast-enhanced ultrasonography is more reliable than conventional ultrasonography in determining the location of breast tumor growth. |
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